下颌骨发育不良、耳聋、早衰特征、脂肪营养不良综合征患者的麻醉管理:病例报告。

Pub Date : 2024-10-10 DOI:10.1186/s40981-024-00747-8
Ryo Sekiguchi, Michiko Kinoshita, Yoko Sakai, Katsuya Tanaka
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引用次数: 0

摘要

背景:下颌骨发育不全、耳聋、类早熟特征和脂肪营养不良(MDPL)综合征是一种罕见的常染色体显性遗传疾病,由于其多系统表现,给麻醉管理带来了独特的挑战。本报告根据我们的病例经验概述了 MDPL 患者的麻醉注意事项:一名患有 MDPL 综合征的 15 岁男性患者在全身麻醉下接受了睾丸摘除术。由于皮肤硬皮病样,插入外周静脉导管具有挑战性。虽然 MDPL 综合征的面部特征提示气道困难,但使用 McGrath™ Mac 视频喉镜成功进行了插管。尽管 MDPL 综合征与脂肪营养不良导致的高甘油三酯血症有关,但该患者的甘油三酯水平正常。在使用噻吗洛尔和七氟醚的过程中,没有出现麻醉延迟等问题:结论:MDPL 综合征需要仔细的术前评估和量身定制的麻醉管理,因为其独特的面部特征可能会给气道带来挑战,而且脂肪营养不良可能会改变麻醉药物动力学。
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Anesthetic management of a patient with mandibular hypoplasia, deafness, progeroid features, lipodystrophy syndrome: a case report.

Background: Mandibular hypoplasia, deafness, progeroid features, and lipodystrophy (MDPL) syndrome is a rare autosomal dominant disorder that presents unique challenges for anesthetic management due to its multisystemic manifestations. This report outlines the anesthetic considerations for MDPL patients based on our case experience.

Case presentation: A 15-year-old male with MDPL syndrome underwent testicular extraction under general anesthesia. Insertion of a peripheral venous catheter was challenging due to scleroderma-like skin. Although the facial features of MDPL syndrome suggested a difficult airway, intubation with a McGrath™ Mac video laryngoscope was successful. Despite MDPL syndrome's association with hypertriglyceridemia due to lipodystrophy, this patient's triglyceride levels were normal. Thiamylal and sevoflurane were used without issues such as delayed emergence from anesthesia.

Conclusions: MDPL syndrome requires careful preoperative assessment and tailored anesthetic management due to potential airway challenges arising from its distinctive facial features and the possibility of altered anesthetic pharmacokinetics associated with lipodystrophy.

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